培美曲塞联合顺铂二线治疗晚期食管癌疗效观察

Clinical observation of pemetrexed combined with cisplatin as second-line treatment in advanced esophageal cancer

目的探讨培美曲塞联合顺铂二线治疗晚期食管癌的临床疗效。方法晚期食管癌患者47例随机分成治疗组（n=24）和对照组（n=23），治疗组静脉滴注培美曲塞500mg／m^2、顺铂25mg／m^2，对照组静脉滴注多西紫杉醇60mg／m^2，2组均以21d为一个疗程。对比2组近期疗效和不良反应。结果治疗组有效率25．0％，疾病控制率66．7％，分别高于对照组的17．4％和34．8％。2组疾病控制率差异有统计学意义（P〈0．05）。2组主要不良反应1～2级骨髓抑制和胃肠道反应。结论培美曲塞联合顺铂二线治疗晚期食管癌有效且相对安全。

Objective To observe the efficacy and adverse effects of pemetrexed combined with cisplatin as second-line therapy in advanced esophageal cancer. Methods A total of 47 patients with advanced esophageal cancer were randomly divided into experimental group （ n = 24） and control group （ n = 23 ）. The experimental group was given intravenous infusion of pemetrexed （500 mg/m^2 ） and cisplatin （25 mg/m^2） per day, 21 d as a cycle. Control group was given docetaxel （60 mg/m^2） per day, 21 d as a cycle. The efficacy and adverse reactions were evaluated and compared in both two groups after each cycle. Results The response rate in control group and experimental group were 17. 4% and 25%, respectively. The disease control rates were 34.8% and 66.7%, respectively, with a significant difference （P 〈 0.05 ）. The main toxic reaction were grade 1～ 2 marrow suppression and gastrointestinal. Conclusions Pemetrexed combined with cisplatin as second-line therapy is potentially useful for advanced esophageal cancer.